Description

Join our Care & Population Health Management team to support safe, effective, and compliant pharmacy services for our Medicaid and Medicare members in our 24 rural counties.

Key Responsibilities

• Support compliance with State, Federal, CMS, and NCQA pharmacy requirements

• Monitor pharmacy utilization and conduct medication reviews

• Assist with PBM oversight, formulary management, and utilization review

• Contribute to Population Health, HEDIS, CMS Stars, MTM, and wellness initiatives

• Review claims, chronic disease medications, and formulary alternatives

• Update pharmacy/MTM policies and support regulatory projects

• Provide clinical and cost analyses of drug classes

• Participate in PBM audits, UM report reviews, and HPMS follow-up

• Collaborate on RRP/DMP cases and weekend claims coverage

Requirements

A.    Professional Competencies

1.     Organization and time management skills

2.     Ability to work effectively with minimal supervision and structure

3.     Knowledge of clinical standards and outcomes

4.     Ability to assess needs, establish goals, develop interventions, and conduct follow-up

5.     Ability to perform critical analyses, plan and organize, and promote client and family autonomy

B.    Educational Requirements and Required Qualifications

1.     At minimum, Bachelor of Science in Pharmacy; Doctor of Pharmacy (PharmD) preferred. UM, population health management, MTM, and managed care organization (MCO)/PBM experience beneficial.

2.     Flexibility and ability to handle multiple tasks. Demonstrated organizational skills and attention to detail. Ability to work effectively with a variety of people both within and outside of the organization. Excellent verbal and written communication skills.

3.     Demonstrated knowledge of, and proficiency in, Word, Excel, and Outlook required. Experience in PowerPoint is a plus.

4.     Ability to sit at a desk or computer station most of the time. Ability to occasionally lift and/or carry such articles as file folders and small boxes up to 20 pounds. Some travel, including overnight travel, required.

C.    Appropriate Licensure and Certification Requirements

1.     Must possess current and unrestricted pharmacy license in Minnesota.

2.     Must attend continuing education sessions each year to support license requirement.

3.     Must be certified in MTM.

4.     Must be certified in CPR.

Summary

Why You’ll Love Working Here

Not only a great job, and place to work, we also have a fantastic benefit package!

This in office/hybrid position offers:

• Medical Insurance
• Vision Materials Coverage
• Long-Term Disability (LTD) Coverage
• Life Insurance
• Pension Plan (PERA)
• 13 Paid Holidays
• Vacation Bank
• Sick Leave Bank
• Volunteer Time Off
• Fitness Room Onsite 

Plus, you’ll make a meaningful impact on the health and well-being of our community while working in a supportive, collaborative environment.

If you’re looking for a career that makes a difference in the communities we serve, we we want to meet you!
Apply today!